HORMONE REPLACEMENT IN MENOPAUSAL WOMEN

更年期女性的激素替代

• 批准号: 6160427
• 负责人: S M HARMAN
• 金额: --
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6160427
• 关键词: aging; blood lipid; body composition; bone density; bone metabolism; clinical research; estrogens; female; follicle stimulating hormone; glucose metabolism; hormone regulation /control mechanism; hormone therapy; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; lipid metabolism; longitudinal human study; menopause; menstrual cycle; physiologic bone resorption; postmenopause; progestins; psychometrics; women's health

Summary of work: As of July 1, 1997, 106 women have been enrolled in the BLSA Perimenopausal Study and have completed their first inpatient assessments and at least one quarterly outpatient GCRC visit. A total of 631 outpatient visits have been completed, ranging from 1 to 16 per woman. A total of 27 inpatient GCRC visits have been completed by 13 women for overnight frequent blood sampling. Of these women, two are classified as perimenopausal (based on measurement of the follicle stimulating hormone, FSH) but they are within two years of their last menses. Analyses of nocturnal GH secretion has been completed for data obtained from ten of the premenopausal women during both early and late phases of one menstrual cycle. There was no difference in GH secretion in between phases of the menstrual cycle. A preliminary analysis of the longitudinal data will be performed when plasma FSH levels are high in at least 6 women. Two more premenopausal women have agreed to be studied within the next three months to complete the study cohort of 15 women. We have also analyzed longitudinal bone mineral density (BMD) measurements at the lumbar spine and hip. The 27 women who remain premenopausal (PRE), were followed > 1 yr (mean 2.5 yrs), and had a mean age of 48.7+/-0.3 yrs. They were compared to 21 women classified as perimenopausal (PERI),with at least one visit > 0.3 yrs before (mean 0.84 yrs) and at least one visit >1 yr after (mean 1.90 yrs) their initial high FSH values. They were followed an average of 2.7 yrs, and had a mean age of 50.3+-0.6 yrs. The PRE group had a significant increase in BMD in the spine while the PERI group had a significant decrease. The BMD values of the two groups were also significantly different . Both the PRE and the PERI groups were losing bone at the femoral neck and trochanteric region. There was no significant difference between PRE and PERI at any hip site.These data confirm the expected accelerated vertebral bone loss during the perimenopausal transition, whereas the similar losses of hip BMD in pre- and perimenopausal women appear not to be distinguishable, suggesting that hip fracture risk may not start to increase until the post-menopausal period. The assays to measure bone biomarkers have been completed for visits up to 2/1/97. Data analyses are underway to determine if serial changes correlate with changes in bone density. Body composition is measured by DEXA and anthropometrics. To date, complete body composition data are available for 21 women who remain premenopausal and 24 who are classified as perimenopausal, as defined above. None of the parameters of body composition measured (weight, body mass index, waist circumference, waist-hip ratio, total fat mass by DEXA scan, or % fat) differed by ANOVA between PRE and PERI groups at baseline. The PERI women exhibit significant longitudinal increases in the estimates of fatness (total fat and % fat by DEXA) compared with the PRE group as well as differences in indices of fat distribution (waist circumference and WHR, p<0.05), and in serum leptin levels (p<0.03), but not in weight or body mass index. These data suggest that changes in body composition may occur early in the menopausal transition.

工作概要：截至 1997 年 7 月 1 日，已有 106 名妇女报名参加 BLSA 围绝经期研究并已完成第一个住院患者 评估和至少每季度一次 GCRC 门诊就诊。 总共有 已完成 631 次门诊就诊，每位女性 1 至 16 次。 13 名女性完成了总共 27 次住院 GCRC 就诊 夜间频繁抽血。 在这些妇女中，有两名被归类为 围绝经期（基于卵泡刺激素的测量， FSH），但距离最后一次月经还不到两年。分析 夜间 GH 分泌已完成，数据来自十个 绝经前妇女在一次月经的早期和晚期 循环。 各阶段之间的 GH 分泌没有差异 月经周期。 对纵向数据进行初步分析 当至少 6 名女性的血浆 FSH 水平较高时进行。 还有两个 绝经前妇女同意在未来三个月内接受研究 完成由 15 名女性组成的研究队列。 我们还分析了纵向骨矿物质密度 (BMD) 测量 在腰椎和臀部。 27 名仍处于绝经前 (PRE) 的女性， 随访时间 > 1 年（平均 2.5 岁），平均年龄为 48.7+/-0.3 岁。 他们与 21 名被归类为围绝经期 (PERI) 的女性进行了比较，结果显示， 至少一次访问 > 0.3 年前（平均 0.84 岁）且至少一次访问 > 1 最初的高 FSH 值一年后（平均 1.90 年）。他们被跟踪 平均年龄2.7岁，平均年龄50.3+-0.6岁。 预组 脊柱 BMD 显着增加，而 PERI 组则有 显着减少。 两组的 BMD 值也 明显不同。 PRE 和 PERI 组都在失败 股骨颈和转子区域的骨。 没有 PRE 和 PERI 在任何髋关节部位都有显着差异。这些数据 确认预期的加速椎骨丢失 围绝经期过渡期，而在围绝经期过渡期，髋部 BMD 也有类似的损失。 和围绝经期女性似乎没有区别，这表明 髋部骨折的风险可能直到绝经后才开始增加 时期。 测量骨生物标志物的测定已经完成 访问次数截至 97 年 2 月 1 日。正在进行数据分析以确定是否连续 变化与骨密度的变化相关。 身体成分通过 DEXA 和人体测量学测量。 迄今为止， 可获得 21 名剩余女性的完整身体成分数据 根据定义，绝经前和 24 名被归类为围绝经期的人 多于。 未测量任何身体成分参数（体重、身体 质量指数、腰围、腰臀比、DEXA 总脂肪量 PRE 组和 PERI 组在基线时的方差分析存在差异。 PERI 女性的估计值呈现显着的纵向增长 与 PRE 组相比，脂肪含量（总脂肪和 DEXA 脂肪百分比） 以及脂肪分布指数（腰围 和腰臀比，p<0.05），以及血清瘦素水平（p<0.03），但不包括体重 或体重指数。 这些数据表明身体成分的变化 可能发生在绝经过渡期的早期。